On Aug. 27 and 28, there was an important conference on the care of dying patients. The conference was the 4th International Conference on Palliative, Medicine and Hospice Nursing. For those of you who may not be familiar with the term, palliative care refers to medical as well as non-medical care provided to a patient usually with life-threatening or terminal illness that is not intended to provide curative treatment but to manage, maintain, and improve the quality of their life.Hospice care, on the other hand, refers to palliative care to patients who are terminally ill and do not have many days to live. "Unlike hospice, palliative care can and should be delivered while patients continue treatment for their diseases," according to Jane E. Brody in her Dec. 3, 2013, article in The New York Times.I was invited to attend the conference as one of two keynote speakers, and thus was able to hear some presentations, and review the proceedings of the conference. Presenters came from all over the world, which included Canada, Taiwan, Saudi Arabia, Belgium, Sweden, Australia, South Africa and the United States. The conference was cozy with quality presentations.Dr. Buga from the City of Hope, California, made a good introduction of the End of Life Option Act that was enacted in California, June 9, 2016. The City of Hope is a well-known cancer treatment center as one of the designated National Cancer Institutes. His presentation included a sad story of a patient who passed away in a car going home after taking the prescribed drug while he was driving.Dr. Buga also made a presentation suggesting prescribers of opioids be aware that opioids for pain management can cause aberrant behavior in patients, meaning that those using opioids may behave strangely. This may lead to determining these patients as drug addicts, when in fact they are simply reacting to prescribed opioids.The likeable Yvonne Heath from Canada provided advice for medical professionals that she learned during her 30 years of work in the profession. This included that the best time to talk about, plan and prepare for grief is when we are young and healthy, while the next best time is now, and that it takes a village to support the ill, the caregiver, the dying, the bereaved and each other.Dr. Johan Menten from Belgium dealt with the question of whether a cardiac pacemaker would lengthen the dying process or postpone death in palliative care unit patients. Based on his own experience, Dr. Menten answered that pacemaker patients die two to six days earlier than their matched non-pacemaker patients, and stated that pacemakers would not lengthen the dying process.Dr. Anna Klarare of Sweden stressed the importance of teamwork and 24/7 availability of the palliative care unit, especially since persons with life threatening illness are increasingly cared for and die at home. Dr. Klarare notes that families and patients experience security and continuity of care due to 24/7 availability.Ching Wan Cheng with four co-authors demonstrated the effectiveness of animal-assisted therapy especially for older adult palliative patients. Benefits of the animal-assisted therapy included better cognitive function, stabilization of mental status and increased socialization.Dr, Johan Menten and his five co-authors from Belgium tested the hypothesis that patients die mostly in the night, more in the weekend, and more in winter than in summer. Based on the 2,774 patients who passed away at the University Hospital of Leuven from 1999 to 2015, they found the hypothesis to be false. They found natural deaths in the palliative care unit to have been spread equally over the day, over the week, and over the year.Angela Sun of the Health Resource Center, USA, made an interesting presentation by posting the question of whether art therapy could be incorporated into palliative care programs among Asian Americans.According to Ms. Sun, the Chinese Community Health Resource Center conducted a needs assessment among seven community members through a focus group utilizing qualitative data collection method.All participants expressed interest in attending an art therapy program to promote healing and reduce anxiety. The types of art therapy participants highlighted were calligraphy, painting, singing, and, interestingly, ballroom as well as line dancing.Finally, a presenter told a sad story of his experience as a caregiver for his wife of over 40 years. The only request his wife made during the long period of cancer treatment at a local cancer center that claims to be the best in the world was to let her die without pain. None of the four oncologists at the two cancer centers, according to the presenter, gave the prescription for pain control when the patient was sent home for her last days.

Chang Se-moon (changsemoon@yahoo.com) is the director of the Gulf Coast Center for Impact Studies.